Harley’s Pediatric Ophthalmology

540 Pages·2013·46.872 MB·English

by  Leonard B. Nelson MD, Scott E. Olitsky MD

(c) 2015 Wolters Kluwer. All Rights Reserved.
Harley’s
Pediatric
Ophthalmology
Sixth Edition
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iii
Harley’s
Pediatric
Ophthalmology
Sixth Edition
Editors
Leonard B. Nelson, MD, MBA
Director, The Wills Eye Strabismus Center
Co-Director, Department of Pediatric Ophthalmology
and Ocular Genetics, Wills Eye Hospital
Associate Professor of Ophthalmology and Pediatrics
Jefferson Medical College
Thomas Jefferson University
Philadelphia, Pennsylvania
Scott E. Olitsky, MD
Professor of Ophthalmology
Children’s Mercy Hospitals and Clinics
University of Missouri - Kansas City School of Medicine
Kansas City, Missouri
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Fifth Edition © 2005 by Lippincott Williams & Wilkins
Fourth Edition © 1998 by W.B. Saunders
Third Edition © 1991 by W.B. Saunders
Second Edition © 1983 by W.B. Saunders
First Edition © 1975 by W.B. Saunders
All rights reserved. This book is protected by copyright. No part of this book may be reproduced in
any form by any means, including photocopying, or utilized by any information storage and retrieval
system without written permission from the copyright owner, except for brief quotations embodied in
critical articles and reviews. Materials appearing in this book prepared by individuals as part of their
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Printed in China
Library of Congress Cataloging-in-Publication Data
Harley’s pediatric ophthalmology. -- Sixth edition / editors, Leonard B. Nelson, Scott E. Olitsky.
p. ; cm.
Pediatric ophthalmology
Preceded by Harley’s pediatric ophthalmology / editors, Leonard B. Nelson,
Scott E. Olitsky. 5th ed. c2005.
Includes bibliographical references and index.
ISBN 978-1-4511-7283-6
I. Nelson, Leonard B., editor of compilation. II. Olitsky, Scott E., editor of compilation. III.
Title: Pediatric ophthalmology.
[DNLM: 1. Eye Diseases. 2. Child. 3. Infant. WW 600]
RE48.2.C5
618.92'0977--dc23
2013020629
Care has been taken to confirm the accuracy of the information presented and to describe generally
accepted practices. However, the authors, editors, and publisher are not responsible for errors or
omissions or for any consequences from application of the information in this book and make no
warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents
of the publication. Application of the information in a particular situation remains the professional
responsibility of the practitioner.
The authors, editors, and publisher have exerted every effort to ensure that drug selection and
dosage set forth in this text are in accordance with current recommendations and practice at the time of
publication. However, in view of ongoing research, changes in government regulations, and the constant
flow of information relating to drug therapy and drug reactions, the reader is urged to check the package
insert for each drug for any change in indications and dosage and for added warnings and precautions.
This is particularly important when the recommended agent is a new or infrequently employed drug.
Some drugs and medical devices presented in the publication have Food and Drug Administration
(FDA) clearance for limited use in restricted research settings. It is the responsibility of the health-care
provider to ascertain the FDA status of each drug or device planned for use in their clinical practice.
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This book is dedicated to our wives, Helene and Andrea,
for their unending understanding patience, support,
and love in pursuit of our academic endeavors.
This book is also dedicated to the memory of
Robison D. Harley, MD, who we will forever owe a debt
of profound gratitude for his leadership and mentorship,
and for giving us the opportunity to continue to provide the
pediatric ophthalmology community an outstanding
treatise in the specialty.
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Contributors
Nagham Al-Zubidi, MD David K. Coats, MD Andrew G. Lee, MD
Neuro-Ophthalmology Fellow Associate Professor of Ophthalmology and Professor of Ophthalmology, Neurology,
Department of Ophthalmology Pediatrics and Neurosurgery
The Methodist Hospital Baylor College of Medicine Department of Ophthalmology
Department of Ophthalmology Texas Children’s Hospital Weill Cornell Medical College
Well Cornel Medical College Houston, Texas Chair
Houston, Texas Department of Ophthalmology
Forrest J. Ellis, MD The Methodist Hospital
J. Bronwyn Bateman Assistant Professor of Pediatrics and Houston, Texas
Clinical Professor of Ophthalmology Ophthalmology
David Geffen School of Medicine Case Western Reserve University Alex V. Levin, MD, MHSc
University of California School of Medicine Pediatric Ophthalmology and Ocular
Los Angeles, California Co-Director of Pediatric Ophthalmology Genetics
and Strabismus Wills Eye Institute
William E. Benson, MD Rainbow Babies and Children’s Hospital Thomas Jefferson University
Professor of Ophthalmology Consultant for Ophthalmic Plastic and Philadelphia, Pennsylvania
Jefferson Medical College Orbital Surgery
Thomas Jefferson University University Hospitals of Cleveland Timothy P. Lindquist, MD
Attending Surgeon Cleveland, Ohio Department of Ophthalmology
Wills Eye Hospital University of Kansas Medicine
Philadelphia, Pennsylvania Sharon F. Freedman, MD Children’s Mercy Hospitals and Clinics
Professor of Ophthalmology Kansas City, Missouri
Gary C. Brown, MD, MBA Professor of Pediatrics
Professor of Ophthalmology Duke Eye Center Grace T. Liu, MD
Jefferson Medical College Durham, North Carolina Pediatric Ophthalmic Consultants
Thomas Jefferson University Department of Pediatric Ophthalmology
Director of Retina Service Nandini G. Gandhi, MD New York University
Wills Eye Hospital Assistant Professor of Ophthalmology New York, New York
Co-Director of Center for Value-Based University of California
Medicine Davis, Sacramento, California David B. Lyon, MD, FACS
Adjunct Senior Fellow Associate Professor
Leonard Davis Institute of Health Kammi B. Gunton, MD Department of Ophthalmology
Economics Assistant Surgeon of Pediatric Ophthalmology Eye Foundation of Kansas City
Philadelphia, Pennsylvania Wills Eye Hospital Vision Research Center, University
Philadelphia, Pennsylvania of Missouri-Kansas City School of
Melissa M. Brown, MD, MN, MBA Medicine
Adjunct Professor of Ophthalmology Denise Hug, MD Kansas City, Missouri
University of Pennsylvania Assistant Professor of Ophthalmology
Director of Center for Value-Based University of Missouri Leonard B. Nelson, MD
Medicine Children’s Mercy Hospitals and Clinics Director
Adjunct Senior Fellow Kansas City, Missouri The Wills Eye Strabismus Center
Leonard Davis Institute of Health Co-Director
Economics Leila M. Khazaeni, MD Department of Pediatric
Philadelphia, Pennsylvania Department of Ophthalmology Ophthalmology and Ocular
Loma Linda University Health Genetics
Robert A. Catalano, MD, MBA Loma Linda, California Wills Eye Hospital
Associate Professor of Ophthalmology Associate Professor of Ophthalmology and
Albany Medical College Laura Kirkeby, CO Pediatrics
Medical Director of Albany Medical Orthoptist Jefferson Medical College
Center Hospital Scripps Clinic Thomas Jefferson University
Albany, New York San Diego, California Philadelphia, Pennsylvania
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CONTRIBUTORS vii
Scott E. Olitsky, MD James D. Reynolds, MD William Tasman, MD
Professor of Ophthalmology Professor and Chairman of Ophthalmology Professor and Chairman of Ophthalmology
Children’s Mercy Hospitals and University at Buffalo School of Medicine Thomas Jefferson Medical College
Clinics Department of Ophthalmology Ophthalmologist-in-Chief
University of Missouri - Kansas City Ross Eye Institute Wills Eye Hospital
School of Medicine Buffalo, New York Philadelphia, Pennsylvania
Kansas City, Missouri
Donald P. Sauberan, MD James F. Vander, MD
Eye Surgical Associates Clinical Professor of Ophthalmology
Gregory Ostrow, MD
Lincoln, Nebraska Jefferson Medical College
Director
Thomas Jefferson University
Pediatric Ophthalmology and Adult
Bruce M. Schnall, MD Attending Surgeon for Retina Service
Strabismus
Associate Surgeon- Pediatric Ophthalmology Wills Eye Hospital
Scripps Clinic
Wills Eye Institute Philadelphia, Pennsylvania
San Diego, California
Philadelphia, Pennsylvania
Rudolph S. Wagner, MD
Evelyn A. Paysse, MD Carol L. Shields, MD Clinical Professor of Ophthalmology
Professor of Ophthalmology and Associate Director University of Medicine and Dentistry
Pediatrics Ocular Oncology Service of New Jersey
Baylor College of Medicine Wills Eye Hospital Director of Pediatric Ophthalmology
Physician Professor of Ophthalmology Institute of Ophthalmology and Visual
Pediatric Ophthalmology Jefferson Medical College Science
Texas Children’s Hospital Thomas Jefferson University University Hospital
Houston, Texas Consultant Newark, New Jersey
Ocular Oncology
Christopher J. Rapuano, MD Children’s Hospital of Philadelphia Eric D. Weichel, MD
Professor of Ophthalmology Philadelphia, Pennsylvania Director of Vitreoretinal Surgery
Jefferson Medical College Department of Ophthalmology
Jerry A. Shields, MD
Thomas Jefferson University Walter Reed Army Medical Center
Director
Director and Attending Surgeon Washington, District of Columbia
Ocular Oncology Service
Cornea Service
Wills Eye Hospital Avery H. Weiss, MD
Co-Director
Refractive Surgery Department Professor of Ophthalmology Associate Professor of Ophthalmology
Wills Eye Institute Jefferson Medical College Affi liate Professor of Pediatrics
Philadelphia, Pennsylvania Thomas Jefferson University University of Washington School of
Consultant in Ocular Oncology Medicine
Children’s Hospital of Philadelphia Chief of Division of Ophthalmology
Jagadesh C. Reddy, MD Philadelphia, Pennsylvania Children’s Hospital and Regional
Consultant
Medical Center
Cornea, Anterior and Refractive Arielle Spitze, MD
Seattle, Washington
Surgery Services Department of Ophthalmology
LV Prasad Eye Institute The Methodist Hospital Sushma Yalamanchili, MD
Hyderabad, India Houston, Texas Department of Ophthalmology
The Methodist Hospital
Michael X. Repka, MD, MBA Mitchell B. Strominger, MD Houston, Texas
Professor of Ophthalmology and Associate Professor of Ophthalmology
Pediatrics and Pediatrics Terri L. Young, MD
Wilmer Eye Institute Tufts University School of Medicine Professor of Ophthalmology,
Johns Hopkins University School of Chief of Pediatric Ophthalmology and Pediatrics, and Medicine
Medicine Ocular Motility Service Duke Center for Human Genetics
Johns Hopkins Hospital Floating Hospital for Children Duke University Medical Center
Baltimore, Maryland Boston, Massachusetts Durham, North Carolina
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Foreword
HARLEY’S PEDIATRIC OPHTHALMOLOGY is an essential Dr Harley was the consummate clinician and teacher. All
resource for all pediatric caregivers to provide them with a com- of us privileged to learn from him and to contribute to this
prehensive source of information about children’s eye problems textbook have felt the responsibility to meet his expectations
to enable understanding and excellent clinical care. When first for excellence and his desire to give back in a meaningful
published 38 years ago, it filled a void that was recognized by way to our colleagues and to our patients.
Dr Harley and Dr Marshall Parks and immediately it became I was asked recently how I became an ophthalmologist.
the Bible for their disciples and many trainees who followed It is of importance to me to acknowledge that I am indebted
these visionary physicians. Writing in the second edition Mar- completely to Dr Harley for the opportunity and a lifetime
shall Parks noted, “Robison Harley has made his mark in medi- of professional and personal fulfillment. I was led by his
cine through this monumental work, and for this we pediatric humanity, love of life, beautiful surgery, humility, tolerance
ophthalmologists are eternally grateful.” Dr Harley recognized of others less skilled than himself, and constant giving to
the rapid development of new information and procedures in others. This treasured textbook, Pediatric Ophthalmology, has
pediatric ophthalmology and encouraged frequent updating been preserved and rewritten by its very capable and expe-
of his original classic textbook. He encouraged frequent revi- rienced editors Dr Nelson and Dr Olitsky and their carefully
sions and would be so delighted with this sixth edition with all selected contributors. Dr Harley gathered and inspired us
its new information and informative illustrations which are so to fulfill his uncompromising expectations for his Pediatric
well presented. He recognized the importance of specialization Ophthalmology and we are collectively rewarded by this
within pediatric ophthalmology and encouraged contributions unique and unrivaled resource to assist all who care for the
from many to his book. In the Foreword of the fifth edition, he health of children’s eyes.
expressed gratitude “for the expertise of the contributors, the I am personally very grateful for their work which has
editors, and the publisher for bringing this splendid volume to made this updated and expanded sixth edition a reality, and
our profession…” which honors Dr Harley and gives back for him a work that
Dr Robison D. Harley died 6 years ago. When I last vis- I know he would appreciate most in return for his lifetime
ited with him shortly before his passing, we discussed cases of mentoring and gifts to each of us.
and this textbook, the goals for which he was passionate. David S. Walton, MD
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Preface
THE SIXTH EDITION of Harley’s Pediatric Ophthalmology contributors include a number of outstanding Wills faculty,
brings a number of changes to the textbook which has served previous fellows, and residents. In particular, the Pediatric
as a benchmark in the subject for more than three decades. Ophthalmology and Ocular Genetics Department at Wills,
Since the publication of the first edition, edited by the late which cares for thousands of children each year, provides a
Dr Robison D. Harley in 1975, the field of pediatrics oph- rare opportunity for the study of an extremely wide variety
thalmology and strabismus has changed markedly. Initially of pediatric ocular disorders.
regarded as an unnecessary subspecialty within the field of We thank all of our contributing authors for their
ophthalmology, pediatric ophthalmology eventually gained knowledge and assistance in the preparation of this book.
acceptance as a fundamental component of the field due to In addition, we are grateful to the publishers at Lippincott
the efforts of early visionaries such as Dr Parks, Dr Costen- Williams & Wilkins who are participating in the fifth decade
bader, and Dr Harley. Today, it is regarded as an essential of a tradition begun by Dr Harley. This textbook, which was
and vital part of both clinical and academic ophthalmology. one of the first extensive books in pediatric ophthalmology,
The latest edition reflects our desire to create the best would not have been possible if it was not for the efforts of
educational and teaching treatise in pediatric ophthalmol- Dr Harley, who passed away shortly after the last edition was
ogy. With that in mind, the chapters are revised, several pre- published. His insight in the ocular problems that occur in
vious chapters were eliminated, and all figures are in color. children as well as his unique ability to teach those insights
New contributors represent some of the recent leaders in to others have benefitted generations of ophthalmologists as
the field and symbolize a “passing of the torch” from one well as the patients we treat.
generation of pediatric ophthalmologists to another. Since
the first edition, Wills, a rich storehouse of clinical material, Leonard B. Nelson, MD, MBA
has provided a major background for this book. Many of the Scott E. Olitsky, MD
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